ArticleThe Annals of thoracic surgery2014
Excess costs associated with complications and prolonged length of stay after congenital heart surgery.
Article in The Annals of thoracic surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
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Who cites it
52 citing papers in PubMed.
- Discharge Barriers and Length of Stay Following Congenital Heart Surgery: A Mixed-Methods Approach.Journal of the American Heart Association · 2026Article
- Changes in mucin expression in the lungs of infant piglets following cardiopulmonary bypass with deep hypothermic circulatory arrest.Journal of investigative medicine : the official publication of the American Federation for Clinical Research · 2026Article
- Immune Unresponsiveness to Cardiopulmonary Bypass Is Associated With Unfavorable Outcome in Infants Requiring Cardiac Surgery.JACC. Basic to translational science · 2026Article
- The PediPERForm Learning Network congenital perfusion registry.The journal of extra-corporeal technology · 2025Article
- The Appraisal of Adults with Congenital Heart Disease: Lesson from Comparison of Surgical Outcomes.Pediatric cardiology · 2025Article
- Article
- Magnitude and Risk Factors for Paediatric Congenital Heart Surgery Complication and its association with Patient Outcomes in the Cardiac Center of Ethiopia.Ethiopian journal of health sciences · 2024Article
- The potential of cardiac xenotransplantation for management of infants with complex congenital heart disease.Translational pediatrics · 2023Review
- Association of preoperative retinal microcirculation and perioperative outcomes in patients undergoing congenital cardiac surgery.Orphanet journal of rare diseases · 2023Observational
- Center-level factors associated with shorter length of stay following stage 1 palliation: An analysis of the national pediatric cardiology quality improvement collaborative registry.American heart journal · 2023Article
- Transcatheter Ductal Stents Versus Surgical Systemic-Pulmonary Artery Shunts in Neonates With Congenital Heart Disease With Ductal-Dependent Pulmonary Blood Flow: Trends and Associated Outcomes From the Pediatric Health Information System Database.Journal of the American Heart Association · 2023Article
- Association of Surgical Complications With Resource Utilization in Adult Congenital Cardiac Surgery.Annals of thoracic surgery short reports · 2023Article
- Textbook outcome for the Norwood operation-an informative quality metric in congenital heart surgery.JTCVS open · 2023Article
- Association Between Birth Weight Z-Scores and Early Outcomes Following Truncus Arteriosus Repair.Pediatric cardiology · 2023Review
- Comparative efficacy and safety between Micro-Percutaneous Nephrolithotomy (Micro-PCNL) and retrograde intrarenal surgery (RIRS) for the management of 10-20 mm kidney stones in children: A systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2022Review
- The horizon of pediatric cardiac critical care.Frontiers in pediatrics · 2022Review
- Regional lung metabolic profile in a piglet model of cardiopulmonary bypass with circulatory arrest.Metabolomics : Official journal of the Metabolomic Society · 2021Article
- Commentary: Just because we can, doesn't always mean we should.JTCVS open · 2021Article
- Pulmonary Vein Index Is Associated With Early Prognosis of Surgical Treatment for Tetralogy of Fallot.Frontiers in pediatrics · 2021Article
- Quality Versus Costs Related to Gastrointestinal Surgery: Disentangling the Value Proposition.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundWhile there is an increasing emphasis on both optimizing quality of care and reducing health care costs, there are limited data regarding how to best achieve these goals for common and resource-intense conditions such as congenital heart disease. We evaluated excess costs associated with complications and prolonged length of stay (LOS) after congenital heart surgery in a large multicenter cohort.
methodsClinical data from The Society of Thoracic Surgeons Database were linked to estimated costs from the Pediatric Health Information Systems Database (2006 to 2010). Excess cost per case associated with complications and prolonged LOS was modeled for 9 operations of varying complexity adjusting for patient baseline characteristics.
resultsOf 12,718 included operations (27 centers), average excess cost per case in those with any complication (versus none) was $56,584 (+$132,483 for major complications). The 5 highest cost complications were tracheostomy, mechanical circulatory support, respiratory complications, renal failure, and unplanned reoperation or reintervention (ranging from $57,137 to $179,350). Patients with an additional day of LOS above the median had an average excess cost per case of $19,273 (+$40,688 for LOS 4 to 7 days above median). Potential cost savings in the study cohort achievable through reducing major complications (by 10%) and LOS (by 1 to 3 days) were greatest for the Norwood operation ($7,944,128 and $3,929,351, respectively) and several other commonly performed operations of more moderate complexity.
conclusionsComplications and prolonged LOS after congenital heart surgery are associated with significant costs. Initiatives able to achieve even modest reductions in these morbidities may lead to both improved outcomes and cost savings across both moderate and high complexity operations.
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